Aortic stenosis: a review on acquired pathogenesis and ominous combination with diabetes mellitus
Abstract Background Aortic stenosis (AS) is a progressive disease, with no pharmacological treatment. The prevalence of diabetes mellitus (DM) among AS patients is higher than in the general population. DM significantly increases the risk of AS development and progression from mild to severe. The in...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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SpringerOpen
2023-04-01
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| Series: | The Egyptian Heart Journal |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s43044-023-00345-6 |
| _version_ | 1797849981788356608 |
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| author | Pranay Wal Shruti Rathore Namra Aziz Yash Kumar Singh Arpit Gupta |
| author_facet | Pranay Wal Shruti Rathore Namra Aziz Yash Kumar Singh Arpit Gupta |
| author_sort | Pranay Wal |
| collection | DOAJ |
| description | Abstract Background Aortic stenosis (AS) is a progressive disease, with no pharmacological treatment. The prevalence of diabetes mellitus (DM) among AS patients is higher than in the general population. DM significantly increases the risk of AS development and progression from mild to severe. The interplay between AS and DM's mechanism is not entirely known yet. Main Body The increased accumulation of advanced glycation end products (AGEs) was linked to increased valvular oxidative stress, inflammation, expression of coagulation factors, and signs of calcification, according to an analysis of aortic stenotic valves. It is interesting to note that in diabetic AS patients, valvular inflammation did not correlate with serum glucose levels but rather only with long-term glycemic management markers like glycated haemoglobin and fructosamine. Transcatheter aortic valve replacement, which has been shown to be safer than surgical aortic valve replacement, is advantageous for AS patients who also have concurrent diabetes. Additionally, novel anti-diabetic medications have been proposed to lower the risk of AS development in DM patients, including sodium-glucose cotransporter-2 inhibitors and glucagon-like peptide-1 receptor agonist that target reduction of AGEs-mediated oxidative stress. Conclusions There are little data on the effects of hyperglycemia on valvular calcification, but understanding the interactions between them is essential to develop a successful treatment strategy to stop or at least slow the progression of AS in DM patients. There is a link among AS and DM and that DM negatively impacts the quality of life and longevity of AS patients. The sole successful treatment, despite ongoing efforts to find new therapeutic modalities, involves aortic valve replacement. More research is required to find methods that can slow the advancement of these conditions, enhancing the prognosis and course of people with AS and DM. Graphical Abstract |
| first_indexed | 2024-04-09T18:54:03Z |
| format | Article |
| id | doaj.art-a05853af31f4485fabe676ad00f6c75b |
| institution | Directory Open Access Journal |
| issn | 2090-911X |
| language | English |
| last_indexed | 2024-04-09T18:54:03Z |
| publishDate | 2023-04-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | The Egyptian Heart Journal |
| spelling | doaj.art-a05853af31f4485fabe676ad00f6c75b2023-04-09T11:20:07ZengSpringerOpenThe Egyptian Heart Journal2090-911X2023-04-0175111710.1186/s43044-023-00345-6Aortic stenosis: a review on acquired pathogenesis and ominous combination with diabetes mellitusPranay Wal0Shruti Rathore1Namra Aziz2Yash Kumar Singh3Arpit Gupta4Pranveer Singh Institute of Technology (Pharmacy)LCIT School of PharmacyPranveer Singh Institute of Technology (Pharmacy)Pranveer Singh Institute of Technology (Pharmacy)Pranveer Singh Institute of Technology (Pharmacy)Abstract Background Aortic stenosis (AS) is a progressive disease, with no pharmacological treatment. The prevalence of diabetes mellitus (DM) among AS patients is higher than in the general population. DM significantly increases the risk of AS development and progression from mild to severe. The interplay between AS and DM's mechanism is not entirely known yet. Main Body The increased accumulation of advanced glycation end products (AGEs) was linked to increased valvular oxidative stress, inflammation, expression of coagulation factors, and signs of calcification, according to an analysis of aortic stenotic valves. It is interesting to note that in diabetic AS patients, valvular inflammation did not correlate with serum glucose levels but rather only with long-term glycemic management markers like glycated haemoglobin and fructosamine. Transcatheter aortic valve replacement, which has been shown to be safer than surgical aortic valve replacement, is advantageous for AS patients who also have concurrent diabetes. Additionally, novel anti-diabetic medications have been proposed to lower the risk of AS development in DM patients, including sodium-glucose cotransporter-2 inhibitors and glucagon-like peptide-1 receptor agonist that target reduction of AGEs-mediated oxidative stress. Conclusions There are little data on the effects of hyperglycemia on valvular calcification, but understanding the interactions between them is essential to develop a successful treatment strategy to stop or at least slow the progression of AS in DM patients. There is a link among AS and DM and that DM negatively impacts the quality of life and longevity of AS patients. The sole successful treatment, despite ongoing efforts to find new therapeutic modalities, involves aortic valve replacement. More research is required to find methods that can slow the advancement of these conditions, enhancing the prognosis and course of people with AS and DM. Graphical Abstracthttps://doi.org/10.1186/s43044-023-00345-6Aortic stenosisDiabetic mellitusValve calcificationCalcified aortic valve stenosisDegenerative aortic stenosis |
| spellingShingle | Pranay Wal Shruti Rathore Namra Aziz Yash Kumar Singh Arpit Gupta Aortic stenosis: a review on acquired pathogenesis and ominous combination with diabetes mellitus The Egyptian Heart Journal Aortic stenosis Diabetic mellitus Valve calcification Calcified aortic valve stenosis Degenerative aortic stenosis |
| title | Aortic stenosis: a review on acquired pathogenesis and ominous combination with diabetes mellitus |
| title_full | Aortic stenosis: a review on acquired pathogenesis and ominous combination with diabetes mellitus |
| title_fullStr | Aortic stenosis: a review on acquired pathogenesis and ominous combination with diabetes mellitus |
| title_full_unstemmed | Aortic stenosis: a review on acquired pathogenesis and ominous combination with diabetes mellitus |
| title_short | Aortic stenosis: a review on acquired pathogenesis and ominous combination with diabetes mellitus |
| title_sort | aortic stenosis a review on acquired pathogenesis and ominous combination with diabetes mellitus |
| topic | Aortic stenosis Diabetic mellitus Valve calcification Calcified aortic valve stenosis Degenerative aortic stenosis |
| url | https://doi.org/10.1186/s43044-023-00345-6 |
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